When assessing a patient with liver cirrhosis, which finding should prompt immediate nursing intervention?

Choice A reason: Melena indicates upper gastrointestinal bleeding, which in a cirrhotic patient is often caused by ruptured esophageal or gastric varices. This is a medical emergency due to the risk of hypovolemic shock and rapid exsanguination, requiring immediate hemodynamic stabilization, airway protection, and endoscopic intervention to control the hemorrhage. Choice B reason: Spider angiomas are small, dilated arterioles commonly found on the skin of patients with cirrhosis due to altered estrogen metabolism. While they are a characteristic diagnostic sign of chronic liver disease, they are a stable finding and do not indicate an acute clinical crisis requiring immediate nursing intervention. Choice C reason: Ascites is the accumulation of fluid within the peritoneal cavity caused by portal hypertension and low albumin levels. Although it requires management through sodium restriction, diuretics, or paracentesis, its presence is a chronic feature of liver failure rather than an acute event necessitating an immediate emergency response. Choice D reason: Jaundice in the sclera, or icterus, results from elevated serum bilirubin levels when the liver cannot adequately process or excrete bile pigments. Like ascites, it is a hallmark sign of hepatic dysfunction, but it is generally a progressive or chronic state rather than a sudden life-threatening complication.